Diseases » Asphyxia

Dyspnea

Dyspnea: Excerpt from Handbook of Signs & Symptoms (Third Edition)

Typically a symptom of cardiopulmonary dysfunction, dyspnea is the sensation of difficult or uncomfortable breathing. It's usually reported as shortness of breath. Its severity varies greatly and is usually unrelated to the severity of the underlying cause. Dyspnea may arise suddenly or slowly and may subside rapidly or persist for years.

Most people normally experience dyspnea when they exert themselves, and its severity depends on their physical condition. In a healthy person, dyspnea is quickly relieved by rest. Pathologic causes of dyspnea include pulmonary, cardiac, neuromuscular, and allergic disorders. It may also be caused by anxiety. (SeeDyspnea: Common causes and associated findings

Cystitis is more common in women than in men because men have a shorter urethra. For men, age is a factor. Men older than age 50 have a 15% higher risk of developing cystitis than younger men.

Paraurethral gland inflammation

Dysuria throughout voiding occurs with urinary frequency and urgency, a diminished urine stream, mild perineal pain and, occasionally, hematuria.

Prostatitis

Acute prostatitis commonly causes dysuria throughout or toward the end of voiding as well as a diminished urine stream, urinary frequency and urgency, hematuria, suprapubic fullness, a fever, chills, fatigue, myalgia, nausea, vomiting, and constipation. With chronic prostatitis, urethral narrowing causes dysuria throughout voiding. Related effects are urinary frequency and urgency; a diminished urine stream; perineal, back, and buttock pain; urethral discharge; nocturia; and, at times, hematospermia and ejaculatory pain.

Pyelonephritis (acute)

More common in females, pyelonephritis causes dysuria throughout voiding. Other features include a persistent high fever with chills, costovertebral angle tenderness, unilateral or bilateral flank pain, weakness, urinary urgency and frequency, nocturia, straining on urination, and hematuria. Nausea, vomiting, and anorexia may also occur.

Reiter's syndrome.

Reiter's syndrome is a predominantly male disorder in which dysuria occurs 1 to 2 weeks after sexual contact. Initially, the patient has a mucopurulent discharge, urinary urgency and frequency, meatal swelling and redness, suprapubic pain, anorexia, weight loss, and a low-grade fever. Hematuria, conjunctivitis, arthritic symptoms, a papular rash, and oral and penile lesions may follow.

Urinary obstruction.

Outflow obstruction by urethral strictures or calculi produces dysuria throughout voiding. (With complete obstruction, bladder distention develops and dysuria precedes voiding.) Other features are a diminished urine stream, urinary frequency and urgency, and a sensation of fullness or bloating in the lower abdomen or groin.

Vaginitis

Characteristically, dysuria occurs throughout voiding as urine touches inflamed or ulcerated labia. Other findings include urinary frequency and urgency, nocturia, hematuria, perineal pain, and vaginal discharge and odor.

Other causes

Chemical irritants.

Dysuria may result from irritating substances, such as bubble bath salts and feminine deodorants; it's usually most intense at the end of voiding. Spermicides may cause dysuria in both sexes. Other findings include urinary frequency and urgency, a diminished urine stream and, possibly, hematuria.

Drugs.

Dysuria can result from monoamine oxidase inhibitors. Metyrosine can also cause transient dysuria.

Special considerations

Monitor the patient's vital signs and intake and output. Administer prescribed drugs, and prepare the patient for such tests as urinalysis and cystoscopy.

Geriatric pointers

Be aware that elderly patients tend to underreport their symptoms, even though older men have an increased incidence of nonsexually related UTIs and postmenopausal women have an increased incidence of noninfectious dysuria.

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Book Source Details

• Book Title: Handbook of Signs & Symptoms (Third Edition)
• Author(s): Springhouse
• Year of Publication: 2006
• Copyright Details: Handbook of Signs & Symptoms (Third Edition), Copyright © 2006 Lippincott Williams & Wilkins.

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More About This Book: Title: Handbook of Signs & Symptoms (Third Edition) Authors: Springhouse Publisher: Lippincott Williams & Wilkins Copyright: 2006 ISBN: 1-58255-402-1

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